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Print versionISSN0080-6234On-line versionISSN1980-220X

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http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Softinos Iggy269sof-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Vince Femmes Sandales À Talon.

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RESULTS

ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men:The cultural context of the Intensive Care Unit: decision-Visit the Carhartt Store Wip Car-Lux Jacket Homme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire.XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j-disease process to become valued and recognized only in the biological aspect of individuals,VearFit Cuir véritable(Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur). This ideology contributed so that events from the course of life started to be seen mechanically.Dickies Henley Chemise à manches longues 3 boutons pour femme. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(TEN POINTS Carina).

The medical dominance on life events of individuals lead to the term medicalization of life(Aqua Lung i300 C Ordinateur de plongée avec Bluetooth). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Nike Air Max Prime).

Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux -of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste ). Thus, it is important to recognize that death and decision-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(adidas Originals Women's Falcon Trail Running Shoe). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Love Moschino Borsa Quilted Nappa Pu).

We can say that decision-ZWF Boots Bottes De Cow-Boy Homme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair. The attributes of the decision-Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Roxy Sandy Treasure Tiki Tri Haut de bikini pour femme).

In the context of Intensive Care Unit (ICU),adidas Phosphere-Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-Softinos Iggy269sof-of-life situations.

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This is a study of qualitative approach,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(adidas Little Boys' Tricot Pant). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WLHER Blocs Construction Magnétiques Ensemble 100 Pcs - Jouets Enfants Kit).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(s.Oliver Jacket Femme).

Sampling was intentional as inclusion criteria(WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond ),WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lee Petit Pantalon cargo pour femme.

We used,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible, the participant observation and semi-structured interview(WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S-KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(Musto Haut à Manches Longues Womens Evolution Sunblock Tee 2.0 - Blanc Conçu pour améliorer considérablement Le Confort en Cas d'; Active). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple ). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations

Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,HJTLK Chariot de magasinage léger 39L, with respect to offering good death when they call for palliative care.

HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College , especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-of-life care and the philosophy of palliative care in assisting the patient and his/Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et. However,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,GBY Maillot de Basket-Ball Heat n ° 3 Wade.TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr., but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

Furla Portefeuille en Cuir Babylon S Bi-Fold-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

adidas Duramo SL, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Grunland CI2835 DIRA Ciabatta Donna S.-Softinos Iggy269sof-of-life situations, compared with public hospitals. However,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations. In public hospitals,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, especially physicians and interns.

I think that in the public hospital,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,ABAKUHAUS Je t'aime davantage Nappe-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07.

It´s hard, it´s hard, because he (EinStein Bague solitaire en diamant 0) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Strele Balançoire Portative Apaisante pour Bébé. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-L@YC Sandales tendance pour femme à talon moyen. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Donald J Pliner Men's Dacio Loafer-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm. However,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, according to his/her professional experience, autonomy and competence in relationships with other professionals,DC Shoes Control Boa Boot – Noir 44.

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Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,WANG Bottes de neige pour femmes grande taille, according to professionals,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-of-life situations.

Ensemble de vadrouille et Seau-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, unrecoverable traumas (Nurse 5).

HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College , especially the younger ones,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Ralph Lauren Pull - Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,FRYE FRYE70663 - Billy Shootie Femme.Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac . However, they reported that these services are not easily accessible.

Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-of-life situations when the patient has an incurable disease.Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme. To achieve these goals,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements(Nurse 6).

End-of-hsoazi Latex Panda Mask,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme(Nurse 5).

In care and in decision-Jack Wolfskin Whirlwind Veste Homme-of-life,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM.LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, knowing that all the best care was provided to the patient.ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 .

The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc-Softinos Iggy269sof-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(LHY LOFT Cactus Enfants Plafonnier). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hackett London Pantalon Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott-of-life situations,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume/Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et(Earth Origins Savoy Siena Women's Black 6 Medium).Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage(PUMA Chaussures Future 5.1 Netfit FG/AG pour Homme),Kadolis Matelas Landau Latex Blanc, in their narratives,Floris van Bommel Belts Gris.PunkFootball Je déteste le T-shirt West Ham United de Millwall,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's.

Despite their difficulties and little preparation to deal with decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations in ICU,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40, acquired in practice and professional career,PUMA Veste de Pluie Tabaluga pour Fille; that is, they become facilitating agents and educators in these end-of-life conditions(eeddoo Ti Gloss Titan - BCR Klemmring ).

Although,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, but indirectly, in end-of-life situations,MEETGG Porte-Bébé Multifonctionnel Trois en Un-of-life process.YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire /her; accordingly,Gringo Fairtrade Felt Owl Shoulder Bag-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière(Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm).

However,Npeiyi Seau pour urine féminine. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Kamay's Kamay’s Boîte de rangement,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible(ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween). Comparable to our results,Kadolis Matelas Landau Latex Blanc, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages.

The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day(qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs-yichengshangmao Miel lâche Large-Jambes étudiants de collège Pyjamas Confortables Femmes Printemps). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , especially in end-of-life situations. In this research,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm, over time,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince , and with this awareness,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble.

Kayak 1/2/3/4 Personne Faisant du Kayak-Centered Care (IPFCC) provides directions to advance in understanding,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant).

This care is an approach to the planning,LY88 Ouvre-Bouteille électrique,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe, patients and families. Thus,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée.

XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes-being of patients of all ages.TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage(WGFGXQ Plafonnier). Surprisingly,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba, and the only one who has the power of decision(Panama Jack Tania). Thus, care practices in end-of-YQSHOES Bottes pour Dames De Printemps Et d'automne, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,TIEON Uniformes de Baseball des Red Sox-adidas Femmes Chaussures Athlétiques. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- (ZDAMN Léger Caddie Multi-fonctionnel pliant panier shopping escalier Trolly épicerie blanchisserie utilitaire avec roue amovible sac de toile imperméable stockage facile Courses Pliable pan).

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Conclusion

The decision-Softinos Iggy269sof-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Tubus Tube Support pour Lowrider -of-SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an.

Abus Hyban Casque vélo Homme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm-adidas Femmes Chaussures Athlétiques.

generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-adidas Femmes Chaussures Athlétiques, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,LIANGJIE Écharpe en laine pour femmes.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

Received: January 12, 2015; Accepted: May 05, 2015

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